Cardiovascular System

Question 1

Name three healthcare associated infections

Answer 1

Methicillin resistant Staph aureus (MRSA)
Clostridium difficille
Norovirus

Question 2

When taking blood pressure measurement what does the top and lower number represent?

Answer 2

Top number is systolic blood pressure – the maximum pressure. This occurs during ventricular contraction.
Bottom number is diastolic BP – the lowest pressure. This occurs during ventricular relaxation.

Question 3

Unstable angina is a medical emergency. True or false

Answer 3

True

Question 4

Name four things you can do to reduce your risk of contracting an infection via a sharps injury

Answer 4

Use equipment with in-built safety features such as a cannula with a sheath that forms over the needle when withdrawn.
Use a sharps bin – take it to the place where you are doing the procedure.
Wear gloves.
Don’t over-fill the sharps bin (2/3 marker line).
Follow appropriate procedure if an injury occurs.

Question 5

What are the features of an arterial foot ulcer?

Answer 5

“Punched out” appearance
Smooth edges
Usually lateral aspect of foot
Reduced or absent foot pulses
Lack of leg hair

Question 6

Troponin C is a protein that is specifically released from myocardial muscle. True or false.

Answer 6

False - Troponin T and troponin I are specific to myocardial muscle.

Question 7

Name a possible complication of myocardial infarction

Answer 7

Heart failure
Pericarditis
Rupture of valve papillary muscles
Arrhythmia
Death

Question 8

A patient with an arterial-brachial pressure index of 0.5 indicates peripheral vascular disease. True or false

Answer 8

True (any value <0.9)

Question 9

Name two causes of secondary hypertension

Answer 9

Hyperthyroidism
Cushing’s syndrome (elevated cortisol)
Phaeochromocytoma
Renal artery stenosis

Question 10

20% of hypertension is classified as “secondary hypertension”. True or false

Answer 10

False - 5%

Question 11

Which ribs are true ribs, and which are false? Which are the floating ribs?

Answer 11

True ribs = I-VII
False ribs = VIII-XII
Floating ribs = XI and XII

Question 12

What are the three bones of the thoracic cage?

Answer 12

Sternum
Clavicle
Scapula

Question 13

What is the name of the joint between the sternum and the clavicle?

Answer 13

Sternoclavicular joint

Question 14

What is the name of the joint between the scapula and the clavicle?

Answer 14

Acromioclavicular joint

Question 15

What are the three parts of the sternum?

Answer 15

Manubrium
Body
Xiphoid Process

Question 16

Where is the jugular notch located?

Answer 16

On the upper border of the manubrium

Question 17

What are the different divisions and sub-divisions of the mediastinum?

Answer 17

Superior
Inferior
Anterior
Middle
Posterior

Question 18

What separates the inferior and superior mediastinum, and what plane is this found?

Answer 18

Sternal angle – transverse plane

Question 19

What branch/branches arise from the right coronary artery?

Answer 19

Posterior interventricular branch

Question 20

What branch/branches arise from the left coronary artery?

Answer 20

Circumflex branch

Anterior interventricular branch

Question 21

What does right dominancy refer to in the heart?

Answer 21

The posterior interventricular branch arises from the right coronary artery, not the left.

Question 22

What does the autonomic nervous system do to heart rate?

Answer 22

Sympathetic – speeds up the rate of contraction – speeding up heart rate.
Parasympathetic – slows down the rate of contraction – slowing heart rate.

Question 23

What are the three branches of the aortic arch?

Answer 23

Brachiocephalic trunk – Right common carotid and right subclavian
Left common carotid
Left subclavian

Question 24

At what vertebral level does the descending thoracic aorta pass through the diaphragm?

Answer 24

T12

Question 25

At what vertebral level does the oesophagus pass through the diaphragm?

Answer 25

T10

Question 26

At what vertebral level does the inferior vena cava pass through the diaphragm?

Answer 26

T8

Question 27

Where must you position a stethoscope to hear the heart valve sounds?

Answer 27

Downstream from the flow of blood flowing through the valves.

Question 28

Which valve would you hear at the medial end of the right second intercostal space?

Answer 28

Aortic valve

Question 29

Which valve would you hear at the medial end of the left second intercostal space?

Answer 29

Pulmonary valve

Question 30

At which position would you auscultate the mitral valve?

Answer 30

Left fifth intercostal space at the midclavicular line

Question 31

At which position would you auscultate the tricuspid valve?

Answer 31

Left of the lower part of the sternum, near the fifth intercostal space

Question 32

What is pericardial effusion? What can this cause?

Answer 32

Compression of the heart by an accumulation of fluid in the pericardial sac. Cardiac Tamponade.

Question 33

What is the name of the string-like structures attached to the tricuspid and mitral valves? What do they do?

Answer 33

Chordae tendineae. These anchor the valves to prevent them from inverting.

Question 34

What is HCAI?

Answer 34

Healthcare Associated Infections. An infection because of direct contact with the healthcare system, symptoms of which usually develop after 48 hours of admission to hospital.

Question 35

What are the golden rules of physical examination?

Answer 35

``` Introduce yourself Confirm patient’s identity Consent for procedure(s) Wash your hands Stand to patient’s right Make sure patient is comfortable Explain each step ```

Question 36

What is the term for an individual finding breathing difficult?

Answer 36

Dyspnoea

Question 37

What is the term for the cessation of breathing?

Answer 37

Apnoea

Question 38

What is the term for respiratory rates less than the normal range?

Answer 38

Bradypnoea

Question 39

Which locations can you check for a patient's pulse?

Answer 39

``` Carotid – neck Brachial – arm Radial – arm Ulna – wrist Femoral – groin Popliteal – behind knee Dorsalis pedis – ankle Posterior tibial – foot ```

Question 40

What is the term for heart rates higher than the normal range?

Answer 40

Tachycardia

Question 41

What is the term for heart rates less than the normal range?

Answer 41

Bradycardia

Question 42

What is the name of the joint between the manubrium and sternal body?

Answer 42

Manubriosternal joint

Question 43

Which part of the spine is the bifurcation of the trachea?

Answer 43

T4-T5

Question 44

What is CABG?

Answer 44

Coronary artery bypass graft

Question 45

Which vessels can be harvested for use in CABG?

Answer 45

Saphenous vein Radial artery Internal thoracic artery

Question 46

What is Cranial Nerve X known as?

Answer 46

The vagus nerve

Question 47

What is the function of the vagus nerve?

Answer 47

Provides parasympathetic innervation to the thoracic viscera and carries visceral afferents from the viscera.

Question 48

Where is the right vagus nerve?

Answer 48

Enters the superior mediastinum between the brachiocephalic vein and the brachiocephalic trunk, and passes posterior to the lung root.

Question 49

Where is the left vagus nerve?

Answer 49

Enters the superior mediastinum posterior to the left brachiocephalic vein and between the left common carotid and left subclavian veins.

Question 50

Where does the phrenic nerve arise and what is its function?

Answer 50

C3, C4 and C5. Supplies the central component of the diaphragm for respiration.

Question 51

What are the layers of the pericardium?

Answer 51

Fibrous pericardium – Strong fibrous layer Serous pericardium :– Parietal layer – lines fibrous pericardium Visceral layer (epicardium) – lines the heart Space between is the pericardial cavity

Question 52

What are the cardiac veins and where are they located?

Answer 52

Great – Found along the anterior atrioventricular groove Middle – Found along the posterior atrioventricular groove Small – Runs between the right atrium and ventricle

Question 53

What are the three layers of a blood vessel wall?

Answer 53

Endothelium – protects the vessel Smooth muscle – allows contraction and dilation Connective tissue – Separates vessel from surrounding tissue